[1]蔡晨婷,唐传玲,赵美,等.个体化心理干预对反复种植失败患者妊娠 结局的影响[J].中国计划生育和妇产科,2020,(7):48-51.
　CAI Chenting,TANG Chuanling,ZHAO Mei,et al.The effect and application value of individualized psychological intervention in treating with recurrent implantation failure[J].Chinese Journal of Family Planning & Gynecotokology,2020,(7):48-51.
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个体化心理干预对反复种植失败患者妊娠 结局的影响
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2020年7期
页码:
48-51
栏目:
辅助生殖研究专栏
出版日期:
2020-07-25

文章信息/Info

Title:
The effect and application value of individualized psychological intervention in treating with recurrent implantation failure
作者:
蔡晨婷; 唐传玲; 赵美; 郑锦霞*
上海市第一妇婴保健院同济大学附属第一妇婴保健院辅助生殖医学科
Author(s):
CAI Chenting; TANG Chuanling; ZHAO Mei; ZHENG Jinxia*
Department of Reproductive Medicine,Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 201024,P.R.China
关键词:
反复种植失败; 心理干预; 辅助生殖技术; 子宫内膜容受性
Keywords:
recurrent implantation failure; psychological intervention; assisted reproductive technology; endometrial receptivity
分类号:
Q 492
摘要:
目的探讨个体化心理干预对反复种植失败（recurrent implantation failure，RIF）患者妊娠结局的影响。方法选取2018年1月至2019年12月在同济大学附属第一妇婴保健院接受辅助生殖技术（assisted reproductive technology，ART）治疗并诊断为RIF不孕症患者124例作为研究对象。患者诊断为RIF后拟进入第1个冻融胚胎移植（frozenthawed embryo transfer, FET）周期时，用随机数字表法将患者分为对照组（61例）和观察组（63例）。对照组给予常规ART相关处理，观察组在对照组的基础上给予心理干预。比较分析两组患者症状自评量表（symptom check list 90, SCL90）、焦虑自评量表（selfrating anxiety scale, SAS）及抑郁自评量表（selfrating depression scale,SDS）评分、子宫内膜厚度及妊娠结局。结果两组患者诊断为RIF后进入第1个FET周期时SCL90、SAS、SDS评分比较，差异均无统计学意义（P＞005）；在胚胎植入前1 d，观察组上述评分均低于进FET周期时（P＜005），而对照组则无显著变化（P＞005），与对照组比较，观察组评分均较低，差异有统计学意义（P＜005）；在胚胎植入后2周，对照组上述评分与胚胎种植前1 d无明显变化（P＞005），而观察组上述评分显著低于胚胎植入前1 d（P＜005）。两组患者在黄体酮转化日子宫内膜厚度均显著大于进FET周期时（P＜005），且与对照组比较，观察组子宫内膜厚度更厚，差异有统计学意义（P＜005）。观察组胚胎种植率为3551 %，显著高于对照组的3010 %（P＜005），但两组临床妊娠率比较，差异无统计学意义（P＞005）。结论对RIF患者进行恰当的心理干预，可显著增强患者对再次ART治疗的信心,有助于缓解患者压抑、恐惧、焦虑等不良情绪，有利于改善子宫内膜容受性、提高胚胎种植率，具有重要的临床应用价值。
Abstract:
Objective To explore the effect of individualized psychological intervention on pregnancy outcomes in patients with recurrent implantation failure (RIF).MethodsFrom January 2018 to December 2019, 124 patients who received assisted reproductive technology (ART) and were diagnosed with RIF infertility at Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine were selected as the research objects. When patients were diagnosed with RIF and were about to enter the first freezethaw embryo transfer cycle, these patients were divided into control group (61 cases) and observation group (63 cases) by random number table method. The control group was given routine ARTrelated treatment, and the observation group was given psychological intervention based on the control group. A comparative analysis of the symptom checklist 90 (SCL90), selfrating anxiety scale (SAS) selfrating depression scale (SDS) scores endometrial thideness thickness and pregnancy outcome of the two groups of patients were done.ResultsThe two groups of patients were diagnosed as RIF and entered the first (frozenthawed embryo transfer, FET) cycle when SCL90, SAS, SDS score comparison, the differences were not statistically significant (P>005); The previous day, the abovementioned scores of the observation group were lower than when entering the FET cycle (P<005), while the control group had no significant changes (P>005). Compared with the control group, the observation group scores were lower, the difference was statistically significant (P<005); 2 weeks after embryo implantation, the above scores in the control group did not change significantly from 1 d before embryo implantation (P>005),while the above scores in the observation group were significantly lower than 1 d before embryo implantation (P<005).The endometrial thickness of the two groups of patients on the day of progesterone conversion was significantly greater than that when entering the FET cycle (P<005),and compared with the control group,the endometrial thickness of the observation group was thicker, the difference was statistically significant (P<005) .The embryo implantation rate in the observation group was 3551 %, which was significantly higher than that in the control group (3010 %) (P<005).But there was no significant difference in the clinical pregnancy rate between the two groups (P>005).ConclusionAppropriate psychological intervention for RIF patients can significantly enhance their confidence in ART treatment again. It is helpful to alleviate the negative emotions such as depression, fear and anxiety of the patients, it is helpful to improve the endometrial receptivity and improve the embryo implantation rate, and has important clinical application value.

参考文献/References:

［1］Simon A, Laufer N. Repeated implantation failure:clinical approach ［J］. Fertility and Sterility, 2012, 97(5): 10391043. ［2］Achache H, Revela. Endometrial receptivity markers,the journey to successful embryo implantation ［J］. Human Reproduction Update, 2006, 12(6): 731746. ［3］Pasch L A, Gregorich S E, Katz P K, et al. Psychological distress and in vitro fertilization outcome ［J］. Fertility & Sterility, 2012, 98(2):459464. ［4］梁瑞晨，张申洪，韩杰，等．接受辅助生殖技术治疗的不孕女性的心理特点及相关因素分析 ［J］．中国生育健康杂志，2018，29（4）： 379382，401． ［5］Sebastian L P, Garrido N, Remohi J, et al. Asynchronous and pathological windows of implantation:two causes of recurrent implantation failure［J］. Human Reproduction, 2018, 33(4): 626635. ［6］张新宇，王丽娜，李蓉，等．反复胚胎种植失败母体因素分析及治疗 ［J］．生殖医学杂志，2019，28（9）：10981102． ［7］宫慧君，何碧嫦，周惠芳．子宫内膜容受性治疗进展 ［J］．辽宁中医药大学学报，2020，22（1）：177180． ［8］Bellver J, Simon C. Implantation failure of endometrial origin: what is new?［J］. Current Opinion Obstets and Gynecol, 2018, 30(4): 229236. ［9］Lensen S, Osavlyuk D, Armstrong, et al. A randomized trial of endometrial scratching before in vitro fertilization ［J］. New England Journal of Medicine, 2019, 380(4): 325334. ［10］倪天翔，颜军昊．反复胚胎种植失败的原因和处理 ［J］．中华产科急救电子杂志，2019，8（3）：155160． ［11］王蕾，颜晓红，林莉，等．高育龄不孕妇女辅助生殖助孕前心理状况调查 ［J］．中华生殖与避孕杂志，2019，39（6）：448452． ［12］方舟，孔伟，张斌，等．不孕症的心理因素分析及心理干预 ［J］．中国性科学，2014，23（10）：8992． ［13］黄品秀，韦继红，韦立红．探讨最适合胚胎种植的子宫内膜厚度 ［J］．生殖医学杂志，2016，25（3）：232236． ［14］王倩，计红苹．心理咨询对实施辅助生殖技术不孕症患者焦虑、抑郁情绪及妊娠率的影响 ［J］．中华现代护理杂志，2016，22（20）：29162918． ［15］周晓景，王芳．焦虑障碍对体外受精胚胎移植患者妊娠结局的影响 ［J］．中国健康心理学杂志，2019，27（2）：208210． ［16］远秀芹．健康教育联合心理干预在体外受精胚胎移植围术期中的应用效果及对母婴结局的影响 ［J］．国际护理学杂志，2019，38（24）：41024105．

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备注/Memo

备注/Memo:
国家自然科学基金面上项目（项目编号：81971383）
更新日期/Last Update: 2020-07-25